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April 8, 2012

Drug-Resistant Malaria Spreading, Say Experts

by editor

Scientists have expressed concerns that resistance to the primary treatment for malaria is increasing, potentially putting thousands of additional people at risk of losing their lives to the disease, according to various media reports.

According to Brendan Trembath of ABC News Australia, lead researchers Francois Nosten, a researcher at the Shoklo Malaria Research Unit in Thailand, and colleagues reported that they had discovered drug-resistant strains of the Plasmodium falciparum parasite on the border between Thailand and Burma.

The decade-long study, which had been published in the journal The Lancet, reports that the drug-resistant strains of the mosquito-spread disease had been discovered in western Cambodia -- more than 500 miles away from where it was more recently observed, according to BBC World Service Science Reporter Matt McGrath. Unless experts can find a way to contain it, it could soon spread to India and Africa, Tan Ee Lyn of Reuters added on Friday.

"This is very worrying indeed and suggests that we are in a race against time to control malaria in these regions before drug resistance worsens and develops and spreads further," Nosten told Daily Mail writer Sadie Whitelocks. "The effect of that happening could be devastating. Malaria already kills hundreds of thousands of people a year -- if our drugs become ineffective, this figure will rise dramatically."

The medicine in question is artemisinin, a drug that is derived from sweet wormwood shrub and which, according to Whitelocks, has been hailed as a "miracle cure" for the disease since 2006. During their research, Nosten and his British and Thai colleagues measured the drug's effectiveness in 3,000 malaria patients from 2001 through 2010. From the beginning of the study until its conclusion, the researchers discovered that the average number of time required to reduce the number of parasites in the blood increased from 2.6 hours to 3.7 hours, she added.

Professor Nicholas White of the Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, in Bangkok, and the Oxford University Centre for Tropical Medicine, blamed the spread of the drug-resistant disease on the incorrect use of artemisinin, as well as subpar or outright fake versions of the treatment, and told Reuters that global health agencies and worldwide government leaders need to redouble their efforts to halt the spread of these strains.

"We need considerable support for Myanmar, leadership, better intelligence on where (drug-resistant malaria) is spreading ... it's like fighting a war," he told the news organization. "We need serious financial support to contain it in this region, otherwise it is going to spread to India and Africa where more people can be affected."

"Either the resistance has moved and it will continue to move and will eventually reach Africa. Or if it has emerged, now that artemisinin is the standard therapy worldwide then it means it could emerge anywhere," Professor Nosten added in comments made to McGrath. "If we were to lose artemisinin then we don't have any new drugs in the pipeline to replace them. We could be going back 15 years to where cases were very difficult to treat because of the lack of an efficacious drug."

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Image Caption: Anopheles albimanus mosquito feeding on a human arm. This mosquito is a vector of malaria and mosquito control is a very effective way of reducing the incidence of malaria. Credit: James Gathany/CDC